Associations between household incense burning and delayed motor development among preterm infants modified by gestational age and maternal educational status

Abstract

Background: Household incense burning is a common ritual behavior in the Asia-Pacific region but has been associated with inferior developmental outcomes in term infants. We aimed to examine these associations among preterm infants. Methods: Information from 1190 mother-infant pairs during 6-and 18-month follow-up to the Taiwan Birth Cohort Study was examined for associations between household incense burning exposure and infant neurodevelopmental milestone achievement using multivariable Cox proportional hazard model with propensity score weighting, along with stratified, sensitivity, and decomposition analysis.Results: Household incense burning exposure was associated with delayed gross motor milestone achievement among all preterm infants according to the Cox model and after propensity score weighting. Meanwhile, associations for delayed development were found in gross motor domain milestones among late preterm infants, while fine motor domain delay was found among other preterm infants. Furthermore, the associations between household incense burning status and gross motor milestone delays were attenuated by the interaction between higher education level and household incense burning exposure status.Conclusions: Household incense burning exposure was associated with delays, and the motor domains affected differed according to degree of prematurity. These | 661 WEI Et al.

Association between household incense burning and executive function in Chinese children

“…In the present study, children who occasionally and frequently exposed to incense fume performed inferior performance on executive function than nonusers. The findings of our study combining the results of these studies described above support the negative associations of incense burning and neurodevelopment among children 13–15 …”

“…We were aware of only three studies investigating the neurodevelopmental effects of incense burning. [13][14][15] More specifically, in a birth cohort study in Taiwan, infants occasionally and persistently exposed to incense smoke at both 6 and 18 months of age exhibited delay in gross motor neurodevelopment milestone including walking with support and walking steadily, and there were more evident associations in the persistent exposure group (e.g., walking with support, OR: 1.26 (95% CI: 1.08-1.47), HR: 1.07 (95% CI: 1.03-1.11) in the occasionally exposed group, OR: 1.24 (95% CI: 1.06-1.45), HR: 1.11 (95% CI: 1.07-1.16) in the persistent exposure group). 13 Data from the same study on preterm infants showed that household incense burning exposure contributed to delayed achievement in walking with support (HR, 95%CI: 1.19, 1.01-1.39) and walking steadily (HR, 95%CI: 1.25, 1.06-1.47), especially for participants whose mothers had lower education level.…”

“…Evidence has shown that the quantity of PM produced by burning incense (>45 mg/g) was larger than that by burning cigarettes (~10 mg/g) 6 . Studies mainly performed in Asia and Arabic regions also suggest consistent associations between incense burning and many adverse health outcomes in children and adults, such as cardiovascular mortality, 7 cancer, 8–10 asthma, 11,12 lower birth weight and smaller head circumference, 2 as well as delayed motor development 13,14 and hyperactive behaviors 15 *…”

“…Therefore, it is plausible to speculate the harmful impact of incense burning on executive function. There were three studies investigating the association between prenatal and infanthood exposure to incense burning and neurodevelopment, which consistently suggested detrimental effects on behavior 15 and gross motor development 13,14 . However, to our knowledge, there is not any prior study exploring the association between incense burning with executive performance among children.…”

“…such as cardiovascular mortality, 7 cancer, [8][9][10] asthma, 11,12 lower birth weight and smaller head circumference, 2 as well as delayed motor development 13,14 and hyperactive behaviors. 15 * Executive function is an umbrella term involving a variety of interrelated, higher-level cognitive skills that were requisite for complex reasoning, goal-oriented activity, and self-regulatory behavior.…”